Form 3461ALT Entry/Immediate Delivery ALT

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No.l65l{x}
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DELIVERY
ENTRYIIMMEDIATE
19 CFR

142.3, 112.16, 142.22,

142.24

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1. ULTIII'IATECONSIGNEENO.

2. IMPORTERNO.

,I. ULTIMATE CONSIGNEE NO.

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8. STATION

3. HTSUSNO.

7. TOTAL INVOICE VALUE

2. IMPORTER NO.

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9, NO.OFPKGS.

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I hereby make application for entry/immediats dellvery. I cortlfy that
tho informatlon provided 13accurate, the bond ls sufflciont, valld, and
current, and that all roqulroments of'19 CFR Part 142 havo beon met.

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